Saturday, 28 August 2010

Save NHS Direct - the next Coalition u-turn?

The NHS Direct phone service is to be scrapped by the Coalition government, in favour of a "cut price" medical advice phone-line which will use fewer nurses and medically trained staff.

John Prescott is on the case, having launched a petition which can be signed at www.savenhsdirect.co.uk. He has the first 500 signatures and anticipates thousands over the weekend, and there is much discussion on twitter of a #savenhsdirect

David Cameron has every right to be rather busy and on leave following the happy news of the birth of his daughter earlier this week.

One thing which might worry the Coalition is the amateurishness to how the news has come out: The Guardian reports that Health Secretary Andrew Lansley accidentally let the cat out of the bag about the decision, appearing to reveal that the official line that a "pilot" scheme was being evaluated was in fact a cover story for scrapping NHS Direct.

The government begins on the back-foot, but is offering "more for less" rhetoric.

The Guardian reports a Department of Health spokeswoman: "It is important that we deliver the best possible service for the public and, in the economic climate, deliver the best value for money.

Whatever the legitimate debate about the best phone-line health advice service, the Coalition's cack-handed handling of the issue means it is now going to struggle if it now wants to claim that the move is not cost-driven.

Like many parents, I have found NHS Direct really useful on a couple of occasions, when not sure whether or not (or how far) to panic when young babies have been ill at night. NHS Direct costs £123 million a year. A large part of the point is to ease pressure on other NHS services, particularly people unnecessarily turning up at accident and emergency as the only well-known way to immediately access the NHS.

"We will develop a 24/7 urgent care service in every area of England, including GP out-of-hoursservices, and ensure every patient can access a local GP. We will make care more accessible by introducing a single number for every kind of urgent care and by using technology to help people communicate with their doctors."

I think they made other references too, including to the 111 number. So we can't say they didn't warn us (there must always have been more to the policy than just changing the number, as that's not remotely worth mentioning to anyone, or indeed worth doing on its own).

Lansley's "admission" may have happened as it did because he didn't think it was news, and was perfectly happy to discuss the policy in more detail with anyone who asked him - it's only a gaffe because nobody had noticed it was already government policy.

I am not sure that there will be a U turn. We are talking about Lansley who is arrogant and bullish. Also, the public mostly think that Cameron's "we will cut the deficit, not the NHS" was a lie, so what does Cameron gain by U-turning on NHS Direct: his cover has already been blown.

I think he will use this to prove that he is a macho state services slasher. I have always predicted that Cameron would use the Tory party conference to announce the new Tory party who will slash the state. (Basically, what the 2009 conference almost was, before they realised that the austerity message was losing them votes.) It was going to happen anyway, it is just happening a month too early.

Expect over the weekend for the legion of spin doctors at the DoH to produce reams of data to show that NHS Direct costs too much and that Lansley is some kind of demi-god for liberating us from them. They will crush the NHS Direct campaign.

While I support the Prescott's campaign against the closure, I think this is the wrong cause. Something far more totemic will come along in the next few months and that cause will be the game changing campaign.